title: Why are sicker patients less satisfied with their medical care? Tests of two explanatory models.
abstract: Two explanations were tested for why patients who are less healthy tend to be less satisfied with their medical care than healthier patients. The explanations were (a) that poor health produces dissatisfaction directly and (b) that poor health produces dissatisfaction through the mediating effect of physicians' behavior. Two studies are presented that measured patients' health status, patients' satisfaction with care, and their physicians' communication as recorded on audiotape. In Study 1, 114 patients had first visits with rheumatologists; in Study 2, 649 patients had continuing-care visits with physicians in internal and family medicine. Causal modeling revealed that the first study supported the direct explanation. The second study also supported the direct explanation, as well as the mediation explanation with respect to the physician's use of social conversation.
authors.affiliation: Department of Psychology, Northeastern University, Boston, Massachusetts 02115, USA. hall1@neu.edu
authors.forename: J A
authors.initials: JA
authors.lastname: Hall
authors.forename: M A
authors.initials: MA
authors.lastname: Milburn
authors.forename: D L
authors.initials: DL
authors.lastname: Roter
authors.forename: L H
authors.initials: LH
authors.lastname: Daltroy
mesh_terms: D000328:Adult; D015142:Baltimore; D001900:Boston; D005163:Factor Analysis, Statistical; D005194:Family Practice; D005260:Female; D006304:Health Status; D006801:Humans; D007388:Internal Medicine; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D012044:Regression Analysis; D012219:Rheumatology; D018434:Sickness Impact Profile